Reappraisal of anatomical liver resection for hepatoblastoma in children

Masaki Honda, MD, PhD; Kaori Isono, MD, PhD; Kazuya Hirukawa, MD; Masahiro Tomita, MD; Hiroki Hirao, MD; Kazuki Hirohara, MD; Yuto Sakurai, MD; Tomoaki Irie, MD, PhD; Teizaburo Mori, MD; Keita Shimata, MD, PhD; Naoki Shimojima, MD, PhD; Yasuhiko Sugawara, MD, PhD; Taizo Hibi, MD, PhD, FACS

Surgery Open Science (Dec 2023)

Reappraisal of anatomical liver resection for hepatoblastoma in children

Masaki Honda, MD, PhD,
Kaori Isono, MD, PhD,
Kazuya Hirukawa, MD,
Masahiro Tomita, MD,
Hiroki Hirao, MD,
Kazuki Hirohara, MD,
Yuto Sakurai, MD,
Tomoaki Irie, MD, PhD,
Teizaburo Mori, MD,
Keita Shimata, MD, PhD,
Naoki Shimojima, MD, PhD,
Yasuhiko Sugawara, MD, PhD,
Taizo Hibi, MD, PhD, FACS

Affiliations

Masaki Honda, MD, PhD: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
Kaori Isono, MD, PhD: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
Kazuya Hirukawa, MD: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
Masahiro Tomita, MD: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
Hiroki Hirao, MD: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
Kazuki Hirohara, MD: Department of Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
Yuto Sakurai, MD: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
Tomoaki Irie, MD, PhD: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
Teizaburo Mori, MD: Department of Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
Keita Shimata, MD, PhD: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
Naoki Shimojima, MD, PhD: Department of Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
Yasuhiko Sugawara, MD, PhD: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
Taizo Hibi, MD, PhD, FACS: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan; Corresponding author at: Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan.

Journal volume & issue: Vol. 16
pp. 215 – 220

Abstract

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Background: The principle of hepatoblastoma (HB) treatment is complete resection. The removal of tumor-bearing section(s) or hemiliver is widely accepted. However, neither the standardized anterior approach for right hepatectomy nor parenchymal sparing anatomical liver resection has been described for HB. Methods: We retrospectively reviewed the clinical course of two pediatric HB patients who underwent extended right hepatectomy using the anterior approach with the liver hanging maneuver and one who underwent parenchymal sparing anatomical liver resection of S4 apical+S8 ventral/dorsal+S7. The critical aspects of surgical techniques are described in detail. Results: In all three patients, R0 resection was achieved without complications and are currently alive without recurrence after an average follow-up of 28 months. Intraoperative cardiac hemodynamics were stable, even in a trisomy 18 patient with cardiac disease. Conclusions: Our findings suggest that these innovative techniques established in adults are safe and feasible for HB in children. These techniques also allow optimal anatomical liver resection to accomplish curative surgery while maintaining the functional reserve of the remnant liver.

Published in Surgery Open Science

ISSN: 2589-8450 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/surgery-open-science/

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